Clinical research in the community

Most patients with high-risk hematologic malignancies are treated in community oncology practices near their resi dence. This is partly due to patients ' ardent desire to be closer to home and trust in local care giv ers. Treatments are increas ingly com plex, even as ini tial ther apy, and more so upon relapse. Improved out comes in the past decade are largely avail able through clin i cal tri als pri mar ily offered through aca demic med i cal cen ters. Limited avail abil ity of clin i cal tri als at com mu nity oncol ogy prac tices is a major con trib u tor to out come disparities among minor i ties, rural, and elderly patients , all of whom are under rep re sented in clin i cal tri als. Between 2003 and 2023, the National Cancer Institute (NCI) established pro grams to address these chal lenges: the Community Clinical Oncology Program, Minority Based Community Clinical Oncology Program, NCI Community Cancer Centers Program, and NCI Community Oncology Research Program. However, disparities have persisted, particularly for pharmaceutical-directed clinical research. Lack of representation in clinical research results in data absenteeism, data chauvinism and hallucination, and a delay in treat ment avail abil ity for high - risk hema to logic malig nan cies in com mu nity prac tice. To address this, the US Congress enacted the Food and Drug Administration Omnibus Act in 2022 to help estab lish diver sity plans that would broaden clin i cal trial patient enroll ment in the United States. We rec om mend using these ini tia tives in com mu nity oncol ogy practices, including the adoption of the DRIVE strategy in collaboration with pharmaceutical companies, as well as using the NCI - established pro grams to pro mote clin i cal trial avail abil ity for patients with high - risk malig nan cies treated in community oncology practices.